Method of effecting neuroprotection using soluble neuregulin isoforms

ABSTRACT

Soluble Neuregulin-1 isoforms representing Posttranslational Neuregulin-1 modifications as medication for effecting neuroprotection in a subject suffering from schizophrenia, bipolar disorder, depression, Alzheimer&#39;s disease, epilepsy, multiple sclerosis (MS), Amylotrophic Lateral Sclerosis (ALS), stroke, traumatic brain injury, and/or spinal cord injury.

This application is a divisional of U.S. Ser. No. 12/742,983 filed May 14, 2010, which is a 35 U.S.C. 371 National Phase Entry Application from PCT/EP2008/009715, filed Nov. 17, 2008, which claims the benefit of U.S. Provisional Application No. 60/988,576 filed on Nov. 16, 2007, the disclosures of which are incorporated herein in their entirety by reference.

The present invention refers to Neuregulin-1 isoforms soluble in physiological solutions representing posttranslational Neuregulin-1 modifications or splice variants as medication in cognition-related neurological disorders, in particular schizophrenia, Alzheimer's and Parkinson's diseases.

BACKGROUND

Neuregulins (NRG) have emerged as key regulators of synaptic signalling. These transmembrane proteins are encoded by four genes (NRG-1, -2, -3 and -4), and their diversity is further increased by alternate RNA splicing and promoter usage and in particular by posttranslational modifications like proteolytic processing which leads to release of soluble isoforms from membrane-bound holoproteins. Moreover there is evidence of phosphorylation and glycosylation (Buonanno and Fischbach 2001). They are characterized by different extracellular domains and are ligands of ErbB receptor tyrosine kinases, which have downstream connotations to neuroinflammation and gene transcription (Holbro and Hynes 2004). In particular, soluble isoforms of NRG-1 are produced from the transmembrane form of NRG through proteolytic cleavage during electrical stimulation and subsequently secreted as activity-dependent synaptic modulators (Ozaki et al. 2004).

A truncated isoform of NRG-1, presumably β1, comprising the N-terminal extracellular domain (ECD) of the entire membrane protein, which has been found to be correlated to learning and memory (Schillo et al. 2005a; WO03/014156). Functional studies have demonstrated, that NRG-1 directly regulates NMDA receptor subunit composition (Ozaki et al. 1997; Eilam et al. 1998). Moreover it has been shown that NRG-1 fragments of this type have neuroprotective properties in vivo by antiapoptotic effects (Xu et al. 2005A; Xu et al. 2005B; Xu et al. 2004).

Very recently it became clear that NRG-1 has a central role in human neurological diseases due to NRG-dependent regulation of NMDA receptors (Schrattenholz and Soskic 2006), and subsequent downstream events like excitotoxicity, neuroinflammation and apoptosis (see FIG. 1 for summary).

There are results showing that NRG 1 plays a pivotal role in conditions ranging from amyotrophic lateral sclerosis, Alzheimer's and Parkinson' disease, to stroke and schizophrenia (Britsch 2007).

This fundamental significance of NRG-1 implies that next to neuroprotection and a positive role in cognition-related learning and memory, NRG-1 represents a crucial neurotrophic factor in regeneration of neuronal tissue after a variety of lesions, in a variety of specific brain regions and cell types.

Obviously it is the crucial factor for maintenance and repair of the integrity of neuronal circuitry: neuroprotective and with roles in correct regeneration after loss of function, as well as in the formation of activity-dependent neuronal plasticity.

The interest in Neuregulin 1 β was further fueled considerably when Kastin et al., 2004, showed that Neuregulin 1 β is able to cross the blood-brain barrier. That opened the perspective for the therapeutic usage of Neuregulin 1 β.

Latest research proved the breadth of application in neuroprotection. Independently it was shown in two publications that Neuregulin 1 is also a substrate of BACE (β-secretase, β-amyloid converting enzyme), which indicates the relevance of Neuregulin 1 in Alzheimer's disease (Glabe 2006; Schubert 2006).

Further, it was found that in Schwann cells neuregulin-1 increases the transcription of the 3-hydroxy-3-methylglutaryl-Coenzyme-A reductase, the rate-limiting enzyme for cholesterol biosynthesis in Schwann cells (Pertusa et al. 2007). This has far reaching implications for all conditions where the myelin sheath is affected, e.g. schizophrenia and multiple sclerosis, or cognition-related functions, where so-called “cholesterol-rich rafts” are involved (Schrattenholz and Soskic 2006). Schwann cell surrounding axons express NRGlreceptors ErbB2/ErbB3 and soluble NRG1α and β under physiological conditions Following denervation, adult Schwann cells leave the contact with axon, change their morphology, stop expressing NRG1β, and upregulate NRG1α and ErbB2/ErbB3 expression (Geuna et al. 2007; Karoutzou et al. 2007).

In addition, genetic epidemiologic research shows the clear association of Neuregulin 1 to schizophrenia and to Alzheimer disease, and in particular to 20 its psychotic forms (Farmer et al., 2007).

Some recent genetic population analyses show, that certain NRG-1-SNP's are associated with Alzheimer and schizophrenia (Go et al. 2005; Scolnick et al. 2006; Ross et al. 2006; Meeks et al. 2006; Farmer et al. 2007). The implications of these findings are related to other proteins of the functional NRG-containing complex depicted in FIG. 1 (ErbB receptor: (Benzel et al. 2007; Thomson et al. 2007; Hahn et al. 2006). There is also an implication for NRG-1 in multiple sclerosis (Esper et al. 2006).

There are results suggesting that the molecular mechanism of the association between NRG1 risk alleles and schizophrenia may include down-regulation of nicotinic acetylcholine receptors of alpha7subtype (Mathew et al. 2007).

According to the present invention it was found that recombinant soluble Neuregulin-1 β isoforms show pharamceutical efficacy in animal models for learning and memory, schizophrenia, Alzheimer's disease and Parkinson's disease. After i.v. administration, Neuregulin-1 β isoforms were active at concentrations which are significantly lower than concentrations of control medicaments.

Thus, a first aspect of the present invention is the use of a recombinant soluble Neuregulin-1 isoform for the manufacture of a medicament for the treatment of neurological conditions, particularly of cognition-related neurological conditions.

A further aspect of the present invention is a pharmaceutical composition or kit comprising (i) a recombinant soluble Neuregulin-1 isoform and (ii) a further medicament particularly for the treatment of neurological conditions, particularly of cognition-related neurological conditions.

Still a further aspect of the present invention is the use of a recombinant soluble Neuregulin-1 isoform for memory and cognition enhancement for the manufacture of a medicament.

Still a further aspect of the present invention is a method of treating a neurological condition comprising administering a recombinant soluble Neuregulin-1 isoform in a pharmaceutically effective amount to a subject in need thereof.

Still a further aspect of the present invention is a method for enhancing memory and cognition comprising administering a recombinant soluble Neuregulin-1 isoform in a pharmaceutically effective amount to a subject in need thereof.

Still a further aspect of the present invention is a co-administration of a recombinant soluble Neuregulin-1 isoform together with a further medicament.

According to the present invention, soluble Neuregulin-1 isoforms have been found to be effective for the treatment of neurological conditions, particularly conditions, such as psychotic disorders like schizophrenia, bipolar disorder and depression, neurodegenerative disorders, like Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), or Amylotrophic Lateral Sclerosis (ALS), epilepsy or neurological injury like stroke, traumatic brain injury and spinal chord injury. Preferred is the treatment of schizophrenia, in particular cognition-related aspects of schizophrenia, Parkinson's disease and Alzheimer's disease. Further, the invention also refers to the use of recombinant soluble Neuregulin-1 isoforms for memory and cognition enhancement, particularly for reducing and/or inhibiting memory and cognition loss associated with a neurological condition such as Alzheimer's disease and schizophrenia.

The recombinant soluble Neuregulin-1 isoform is preferably a human Neuregulin-1 isoform, i.e. a recombinant isoform comprising the primary amino acid sequence of a naturally occurring human Neuregulin-1 isoform or a sequence which has a identity of at least 90%, preferably at least 95% and most preferably of at least 98% based on the total length of the recombinant isoform.

The soluble recombinant Neuregulin-1 isoform of the present invention preferably comprises at least a portion of the extracellular domain of the corresponding Neuregulin-1, e.g. at least a portion of the extracellular domain of a human Neuregulin, e.g. human Neuregulin-1 β.

The recombinant soluble Neuregulin isoform of the present invention preferably has a length of up to 250 amino acids, e.g. 150 to 250 amino acids. The molecular weight of the Neuregulin isoform is preferably of about 15 to about 35 K D, particularly about 25 to about 32 K D, as measured e.g. by SDS-polyacrylamide electrophoresis (PAGE). The recombinant soluble Neuregulin-1 isoform, particularly the recombinant Neuregulin-1 β isoform, has an isoelectric point (pl) of about 4 to about 9.5, preferably of about 4 to about 6. The isoform may be an unmodified polypeptide which consists of an unmodified amino acid sequence or a modified polypeptide, wherein the modification may be selected from phosphorylation, glycosylation, methylation, myristylation, oxidation and any combination thereof. In an especially preferred embodiment, the Neuregulin-1 isoform comprises at least one phosphorylated amino acid residue. Further, the present invention encompasses conjugation to heterologous moieties such as poly(alkyleneoxide) moieties, particularly polyethylene glycol moieties.

The recombinant soluble isoforms may be administered according to any route by which effective delivery into the target tissue, e.g. the nervous system, particulary the central nervous system, such as brain and/or spinal chord, is achieved. It was found that pharmaceutically effective concentrations of Neuregulin isoforms may be achieved by systemic administration. For example, the isoforms may be administered by injection or infusion, e.g. by intravenous injection. The isoforms are preferably administered in an amount of 0.1 to 5000 ng/kg body weight, particularly in an amount of 2 to 1000 ng/kg body weight and more particularly in an amount of 3 to 600 ng/kg body weight of the subject to be treated, depending on the type and severity of the condition to be treated. In other embodiments of the present invention the soluble isoforms may also be administered locally, e.g. by direct administration into the central nervous system, e.g. into the spinal chord and/or into the brain. Also administration at higher dosages of up to 500 μg/kg by i.p. or s.c. injections, or inhalation devices are may be considered. Preferably the subject to be treated is a mammal, more preferably a human patient.

The soluble recombinant Neuregulin-1 isoforms may be administered as a stand-alone medication, i.e. as a monotherapy or as a co-medication, i.e. in combination with a further medicament, particularly with a further medicament which is suitable tor the treatment of a neurological condition.

Examples of further medicaments are compounds affecting catecholamine metabolism, acetylcholine esterase inhibitors, MAO-B- or COMT-inhibitors, Memantine-type channel blockers, dopamine or serotonine receptor agonists or antogonists, catecholamine or serotonine reuptake inhibitors or any type of antipsychotic medicaments like clozapine or olanzapine or gabapentin-like drugs, particularly in the treatment of Alzheimer's and Parkinson's diseases, schizophrenia, bipolar disorder, depression or other neurological conditions. Additional examples of further medicaments are neuroprotective agents such as PARP-1 inhibitors, e.g. as disclosed in WO 2006/008118 and WO 2006/008119, which are herein incorporated by reference.

Thus, an embodiment of the present invention refers to the combination of a recombinant soluble Neuregulin-1 isoform as described herein with a medicament for the treatment of psychotic disorders such as schizophrenia, bipolar disorders and depression, e.g. olanzapine or clozapine. A further embodiment refers to the combination of a recombinant soluble Neuregulin-1 isoform and a medicament for the treatment of a neurodegenerative disease such as Parkinson's disease, Alzheimer's disease, MS or ALS. Still a further embodiment refers to the combination of a recombinant soluble Neuregulin-1 isoform and a medicament for the treatment of neurological injury, such as stroke, traumatic brain injury or spinal chord injury.

The combination therapy may be effected by co-administering the recombinant soluble Neuregulin-1 isoform and the further medicament in the form of a pharmaceutical composition or kit, wherein the individual medicaments are administered by separate or common administration.

The Neuregulin-1 isoform may be a Neuregulin-1 Type I, Type II, Type III, Type IV, Type V or Type VI isoform, preferably a Neuregulin-1 β isoform, a Neuregulin-1 α isoform or a Sensory and motor neuron-derived factor (SMDF) isoform, particularly a Neuregulin-1 β isoform and more particularly a human Neuregulin-1 β isoform.

Neuregulin 1 β isoforms are actively transported through the blood brain barrier. The excellent bioavailability of Neuregulin 1 β in the brain after i.v./i.p. Injection, as shown in the Examples paves the way towards a therapeutic application of NRG 1 β.

Its combination of antiapoptotic, myelin-stabilizing, anti-inflammatory properties, together with the direct interaction with BACE opens opportunities in the treatment of stroke, Alzheimer, MS and schizophrenia and other neurological conditions.

As outlined above, the present application encompasses the use of unmodified and modified Neuregulin-1 isoforms, particularly Neuregulin-1 β isoforms. There is evidence that posttranslational modifications like proteolytic processing, phosphorylation and glycosylation take place at certain amino acid residues of the Neuregulin-1, and in particular its extracellular domain. In particular the release of soluble fragments of Neuregulin-1 has been reported (Buonanno and Fischbach 2001; Fischbach 2007). Potential oxidation has been reported as well (Nadri et al. 2007).

The present inventors have obtained evidence that preferred physiologically active Neuregulin-1 β isoforms comprise the extracellular domain of Neuregulin-1 β or a part thereof which has been post-translationally modified. Preferably, the isoforms have been modified by phosphorylation, wherein 1, 2, 3 or more amino acid side chain residues, particularly side chain residues having an OH-group such as Tyr, Ser or Thr, have been phosphorylated. Preferred phosphorylation sites are located at amino acid positions 79-82, 133-136 and/or 158-161 (nomenclature according to Falquet et al., 2002). Further preferred phosphorylation sites are located at amino acids 12-14, 30-32 and/or 85-87. Further potential modification sites are amidation sites, preferably located at positions 22-25 and/or 30-33, glycosylation sites at positions 150-153, 156-159 and/or 204-207, and myristylation sites, preferably located at positions 94-99, 149-154, 168-173, 175-180 and/or 202-207 according to the nomenclature of Falquet et al. 2002.

In the following, the relevance of the experimental data according to the present application are explained with regard to preferred medical indications.

Schizophrenia

Schizophrenia is a serious and disabling mental disorder with symptoms such as auditory hallucinations, disordered thinking and delusions, avolition, anhedonia, blunted affect and apathy. Epidemiological, clinical, neuropsychological, and neurophysiological studies have provided substantial evidence that abnormalities in brain development and ongoing neuroplasticity play important roles in the pathogenesis of the disorder (Arnold et al. 2005).

Schizophrenia is thought to include a disorder of dopaminergic neurotransmission, but modulation of the dopaminergic system by glutamatergic neurotransmission seems to play a key role. This view is supported by genetic findings of the neuregulin- and dysbindin genes, which have functional impact on the glutamatergic system (Muller and Schwarz 2006). What has become increasingly clear is that several regions that are likely to contain genes (including neuregulins) contributing to schizophrenia are also relevant to bipolar affective disorder, a finding supported by recent 25 twin data (Farmer et al. 2007; Owen et al. 2007).

Neuregulin-1, which is a psychosis susceptibility gene with effects on neuronal migration, axon guidance and myelination that could potentially explain findings of abnormal anatomical and functional connectivity in schizophrenia and bipolar disorder (McIntosh et al. 2007).

There is an ever increasing body of evidence of a genetic linkage of Neuregulin 1 to schizophrenia (review: Farmer et al., 2007). The enhancement of glutamate, GABA and nicotinic neurotransmission by Neuregulin-1 (Fischbach 2007; Woo et al. 2007; Li et al. 2007) is relevant in this context, as well as implication with brain inflammation (Hanninen et al. 2007).

The regulation of 3-hydroxy-3-methylglutaryl-Coenzyme-A reductase, the rate-limiting enzyme for cholesterol biosynthesis (Pertusa et al. 2007), important for myelinisation, is assumed to have implications in this condition as well.

The fact that among genetic risk factors common to schizophrenia, bipolar disorder and depression, NRG1 plays an outstanding role, has triggered suggestions that genes implicated in these psychoses such as NRG-1 may eventually provide the basis for classification based on biology rather than symptoms, and lead to novel treatment strategies for these complex brain disorders (Blackwood et al. 2007; Bertram et al. 2007).

The experimental data of the present application demonstrate the effectiveness of administration of a soluble recombinant Neuregulin-1 β isoform in an experimental model of schizophrenia.

Alzheimer's Disease

Initial research by the inventors showed that Neuregulin 1 β is diminished in post mortem sections of hippocampi of brains of Alzheimer's patients as compared to age-matched controls (Sommer et al., 2004) with a clear positive correlation of the soluble fragment of Neuregulin-1 with learning performance in a radial maze test (Sommer et al., 2004).

There are numerous reports demonstrating the role of NRG-1 in activity-dependent synaptic changes (Xie et al. 2006; Kwon et al. 2005; Rimer et al. 2005; Bao et al. 2004; Yang et al. 2005) important for learning and memory (Ozaki et al. 1997; Ozaki et al. 2004; Golub et al. 2004; Schillo et al. 2005b). As shown below, the NRG1β fragment containing the extracellular domain was clearly associated with learning in a behavioural animal model. Showing decreased expression of the protein in post mortem brain slices of the hippocampal regions (responsible for short term memory formation) of Alzheimer patients as compared to age-matched controls could demonstrate the absence of memory-related synaptic activity, in regions of apparently still healthy neurons.

Very recent discoveries (Hu et al. 2006; Glabe 2006; Schubert 2006) show that NRG 1 is processed by BACE 1 (=secretase), an enzyme that helps generate clumps of amyloid-β in the brains of people with Alzheimer disease, which explains the link to Alzheimer's disease, its concomitant role in myelin formation relates to the neurotrophic properties of NRG 1 (Hu et al., 2006; Glabe 2006; Schubert 2006). The enzyme. BACE1 (beta-site amyloid precursor protein-cleaving enzyme 1), is required to cleave amyloid-β from a larger precursor. (After BACE1-mediated cleavage, the presenilin-containing complex γ-secretase makes the final cleavage, liberating amyloid-β.

The cleavage of NRG by secretases is crucial for nerve myelination. Just like amyloid precursor protein, neuregulin 1 is also cleaved by -secretase. Proteolytic cleavage of neuregulin 1 by β-secretase is critical for peripheral nerve myelination by Schwann cells. Drugs that target β-secretase could affect peripheral nerve development and function.

The in initial observation was by the group of Haass (Willem et al. 2006), who found that BACE1 seems also to be required for myelination. Peripheral nerve myelination occurs early in life, so it is unclear how BACE1 inhibition might affect older animals. There are indications that BACE1 also has a role in myelination of the central nervous system. Transgenic animals deficient in BACE-1 had myelin defects in the peripheral nerves

Also in the context of neurodegeneration and Alzheimer's disease, the recent discovery of enhancement of glutamate, GABA and nicotinic neurotransmission by Neuregulin-1 (Fischbach 2007; Woo et al. 2007; Li et al. 2007) is relevant.

The experimental data of the present application demonstrate the effectiveness of administration of a soluble recombinant Neuregulin-1 β isoform in an experimental model of Alzheimer's disease.

Stroke, Traumatic Brain Injury

A series of stroke-related in vivo experiments by independent external research in the US, demonstrate neuroprotection by Neuregulin 1 which by itself is antiapoptotic (Xu et al., 2004, 2005 and 2006; Guo et al., 2006) NRG-1 reduces neuronal damage and improves neurological outcome after middle cerebral artery occlusion (a common stroke model) (Xu et al. 2005b; Xu et al. 2004; Xu et al. 2006; Guo et al. 2006).

In the same study about the therapeutic efficacy and mechanism of recombinant human NRG-1 in attenuating brain injury by ischemia/reperfusion, it was found that NRG is antiapoptotic. NRG-1 (3.0 ng/kg) was applied intravascularly 10 min before middle cerebral artery occlusion (MCAO) and subsequent focal cerebral ischemia for 90 min and reperfusion for 24 h.

The data of the present invention demonstrate that administration of recombinant soluble Neuregulin-1 isoforms at low concentration has a significant pharmacological effect and thus is assumed to be effective in models of stroke and traumatic brain injury.

In the following, the present application is explained in more detail by the Figures and Examples given herein below.

FIG. 1: Various reviews and numerous research articles on Neuregulin 1 show the key functional position of NRG 1 as an upstream regulatory principle of mechanisms thought to be pivotal in neurodegenerative diseases, neurological disorders, as well as physiological function:

NRG are key parts of functional complexes, consisting at least of neuregulins (NRG), receptor tyrosine kinases (ErbB receptors), heparansulfate proteoglycans (HSPG) and NMDA receptors (NMDAR), which are transiently and activity-dependent assembled together in cholesterol (CHO)-rich membrane microdomains. In particular the shaping of calcium signals is important for the interaction with subsynaptic scaffolding proteins by posttranslational modifications (PSD-95, by interaction with certain phosphorylated domains, like PDZ- or SH-domains on partner proteins). The PSD-95 complex directly regulates pro-inflammatory enzymes like nitric oxide synthase (NOS, iNOS is inducible, nNOS is neuronal) and Cox-2 (cyclooxygenase-2), which promote their effects in a complex relationship with related, but not necessarily downstream mechanisms, involving NAD+-dependent enzymes like PARP-1 (poly-ADP-ribose polymerase-) and Sir-2 (sirtuin-2); PARG is poly(ADP-ribose) glycohydrolase the complementary and antagonistic enzyme to PARP-1, HDAC are histone deacetylases, the general class of enzymes which includes Sir-2. MPTP stands for the mitochondrial permeability transition pore. DRP-2 is dihydropyrimidinase-related protein 2. Also other important membrane proteins, like certain nicotinic acetylcholine receptors (nAChRα7), GABA_(A) receptors (GABA_(A)R) amyloid precursor protein (APP) and proteases (PS) are transiently organized in lipid rafts and acquire different functional properties outside the usual phospholipid (PL) environment, details in (Schrattenholz and Soskic 2006).

FIG. 2: Summary of learning experiments in Morris water maze: animals treated with a daily dose of 3 ng/kg (i.v.) of the soluble extracellular domain of neuregulins-1 beta (NRG-1 beta-ECD) were significantly better in learning than vehicle treated animals; IAE: inner area entry; IAEF inner area entry frequency; TS: time spent in inner area; DT: distance travelled in inner area.

FIG. 3: Reduction of Amphetamine-induced hyperactivity by NRG-1 beta-ECD, a widely accepted model for schizophrenia. Concentrations ranged from 15 to 600 ng/kg (i.v. injection 15 minutes prior to amphetamine application). A positive control of 0.125 mg/kg Haloperidol was included.

Whereas Haloperidol like other non-typical and typical antipsychotics usually reduce activity below control level (indicated here by dotted lines labelled veh/veh, in blue for crossings and in magenta for rears), NRG-1 beta-ECD reduction asymptotically approaches control levels of activity, but does not cause further reduction. The low effective concentrations of NRG-1 beta-ECD and the absence of negative effects (reduction of activity below vehicle control levels) are the outstanding properties in this model. The effects are significant with p<0.05;

FIG. 4: Summary of learning experiments with APPPS mouse model of cerebral amyloidosis and Alzheimer's disease in a Morris water maze: animals treated with a daily dose of 200 ng/kg i.p. NRG-1 beta-ECD were significantly better in learning than vehicle treated animals; IAE: inner area entry; IAEF inner area entry frequency; TS: time spent in inner area; DT: distance travelled in inner area.

FIG. 5: HPLC quantification of dopamine and its metabolites: The columns labelled with asterisks are highly significant.

Legend S Saline (control) aM acute MPTP aMN acute MPTP and NRG-1 beta-ECD aN acute NRG-1 beta-ECD cM chronic MPTP cMN chronic MPTP and NRG-1 beta-ECD cN chronic NRG-1 beta-ECD

FIG. 6: Metabolism of dopamine by MAO-B and COMT.

FIG. 7: MPTP exposition leads to a significant loss of dopaminergic neurons in the substantia nigra (aMPTP, p=0.0005; and cMPTP, p=0.0075). The ip application of 20 ng/kg of NRG-1 beta-ECD leads to a reversal (aNR-MPTP; p=0.57, i.e. not different from vehicle control) or clear and significant improvement of the MPTP lesion (cNR-MPTP; p=0.0097); in the chronic model (5 days daily ip application of 20 ng/kg of NRG-1 beta-ECD) there is also a significant effect number of dopaminergic neurons (cNR; p=0.0002);

Legend NaCl Saline (control) aMPTP acute MPTP aNR- acute MPTP and NRG-1 beta-ECD MPTP aNR acute NRG-1 beta-ECD cMPTP chronic MPTP cNR- chronic MPTP and NRG-1 beta-ECD MPTP cNR chronic NRG-1 beta-ECD

FIG. 8: Two representative images of 2D-Western blots of brain proteins of APPPS mice stained for Neuregulin-1 β are shown of each, a treated and good learning animal (top) and non-treated animal with inferior learning performance (below).

The numbers in the upper part are pl values of the 2D gel.

FIG. 9: A Western blot experiment compairs the abundance of the NRG-1 β ECD-fragment in post mortem cortical material from Alzheimer patients and controls.

FIG. 10: 2D-PAGE shows, that the acidic isoform of NRG-1 β-ECD, with a pl of approx. 5-5.5 and a molecular weight of approx 25-32 kD in these experiments is clearly diminished in Alzheimer's patients brains.

FIG. 11: is a schematic of the pool used for the Morris Water Maze assessment.

FIG. 12: is a schematic of the pool used for the Morris Water Maze assessment showing the zones for computing the animals' track records.

EXAMPLES General

In all of the following experiments fragments of Neuregulin-1 beta have been used, comprising only the extracellular domain (ECD) of the entire transcript of the human nrg-1 gene. They had a molecular weight of approx 25-32 kD and isoelectric points between approx 5 and 9.5, depending upon phosphorylation and/or glycosylation status.

The physiologically active form of Neuregulin-1 isoform has a pl of approx. 5.5. The physiologically active form has an pl of approx.5.5 (most of the experiments were carried through with a commercially available isoform produced in E. coli, with a molecular weight of 26 kD and an pl of approx.9.0)

This isoform is a recombinant soluble human NRG-1 beta fragment consisting of the first 245 amino acids of NRG-18, purchased from R & D Systems, Inc. (Catalog No. 377-HB-CF). It will be named NRG-1 beta-ECD in the following. This active isoform has a pl of approx. 9.0 We also tested a corresponding fragment of NRG-1 with 8 kD, only comprising the EGF domain, purchased from R&D Systems (Catalog No. 396-HB). This fragment appears to be neuroprotective as well in vitro and in vivo, but was not investigated in depth because of much higher proliferative properties, which raised concerns about cancerogenity.

Example 1 Initial Toxicology Data Indicate that NRG1β (ECD) has No Adverse Effects in Acute Toxicology and In Vitro Mutagenicity Tests

-   -   There was no acute intravenous toxicity in rats: All animals         survived until the end of the study period. No clinical signs         were observed during the course of the study. The body weight of         the animals was within the range commonly recorded for this         strain and age. No macroscopic findings were recorded at         necropsy. The median lethal dose of NRG1β (ECD) after single         intravenous administration to female rats, observed over a         period of 14 days is: LD₅₀ (female rat): greater than 5000 ng/kg         body weight.     -   Daily intravenous administration of Neuregulin over a period of         seven days at dose levels of 50, 200 and 600 ng/kg body weight/d         did not result in any premature death. No clinical signs were         recorded. The treatment did not affect the food consumption and         body weight development. The no observed effect level (NOEL) was         established at 600 ng/kg body weight/d.     -   In the mouse lymphoma thymidine kinase locus assay using the         cell line L5178Y according to the OECD Guideline for the Testing         of Chemicals, No. 476 “In vitro Mammalian Cell Gene Mutation         Test”, NRG1β (ECD) was non-mutagenic.

In the chromosome aberration test in Chinese hamster V79 cells according to the OECD Guideline for the Testing of Chemicals, No. 473, NRG1β (ECD) did not induce structural chromosome aberrations.

Moreover, in none of the animal experiments carried out with regard to efficacy (some of them going on for several months with daily iv applications) did we ever observe adverse effects of NRG1β (ECD).

Application of NRG1β (ECD) in the various animal models described below, was either by intravenous (iv) or intraperitoneal (ip) injections; concentrations were ranging from 3-600 ng/kg.

Example 2 Learning and Memory Spatial Learning with and without NRG-1 Beta-ECD Application Methods:

The Morris Water Maze assesses spatial learning. It requires animals to swim in a water-filled pool and to find a rescue platform submerged just below the surface. It is obligatory that the platform is placed away from the walls of the maze and that animals have reference points visible from the water surface that permit estimation of location, but are not close enough to the target to permit associative learning. The animals are trained that rescue only comes via the platform meaning that all animals which do not find the platform, are guided to the platform and allowed to rest before being removed from the set-up. Therefore, one of the most important reference points for the mouse is the human operator.

The experiment aims at determining two key parameters associated with murine spatial recall:

-   -   the rate at which the mice learn to relocate the platform     -   the ability to retain the information in the short term (within         a training period or overnight)

Animals

The study is performed with two groups of APP/PS mice (Meyer-Luehmann et al. 2006; Radde et al. 2006), one of which is treated by a daily dose of NRG-1 beta-ECD and the other one is sham treated as a control. Each group consists of 8 males which are nine weeks old at the beginning of their first series of experiments.

The first series of experiments started with two subgroups of 8 treated and 8 untreated mice on week 42 and will last for 15 days. Further series of identical experiments will be performed 6, 12, etc. weeks later.

For a second pair of subgroups (8 treated and 8 untreated nine weeks old males) the same series of experiments started on week 48, so the experiments of these subgroups lag exactly 6 weeks behind the ones of the first subgroups.

Apparatus

The learning aptitude of the treated and untreated APP/PS mice is assessed using a circular Morris water maze which should be large enough to provide searching space without exhausting the mouse. Utmost care needs to be taken to keep each detail of the experimental setup as invariable as possible throughout all experiments.

In the current study, a pool of 120 cm diameter is used which is placed at an exactly reproducible position in the lab with always identical orientation. At fixed positions in the pool, a white, translucent, circular platform of 15, 10, or 5 cm diameter is placed that extends to just below the water surface (so it is invisible to the mice) and that the animals can climb on—which is the only means to rest out of the water. To assist climbing, the platform is coated with a gauze grip surface (see FIG. 11).

In order to perform the rescue procedure in probe trials as detailed below, the platform is equipped with a mechanism that allows for automatically raising and lowering it without direct operator intervention. Thus, depending on its height the platform is accessible to the swimming mice or not “On-demand platform” (Buresova et al. 1985).

Platform locations are always situated in a ring shaped, concentric region of the pool with inner and outer diameters ˜40 cm and ˜80 cm, respectively. Four quadrants are defined such that the platform occupies the central region of one of them (the target quadrant). For further details on platform sizes and positions see below.

In order to make sure that platform position is exactly the same throughout an entire series of experiments; a socket will be firmly affixed to the floor of the pool on which the platform can be mounted with a minimum of spatial tolerance. On top of the platform, in its center, there is another mounting for a (proximal) cue sticking out of the water which is well visible on the video recording as well as to the mice swimming in the pool. For a check of platform position, a brief video recording will be taken without an animal but with the cue plugged into the platform whenever the platform or the video camera have been manipulated with in any way.

The water is made opaque using low fat milk powder. The water temperature should be cold enough to encourage searching for an exit but not so cold 15 that the animals suffer or are exhausted. As a fair compromise, water temperature is monitored at the start of each experiment and modulated with either warm water or ice flakes to 18° C. Between individual trials, temperature is readjusted as needed.

Four distal cues (of different simple geometric shapes and different colors, height ˜20 cm) are attached ˜20 cm above the sides of the pool, one in each quadrant. Care is taken to place each cue in exactly the same location throughout all experiments. The entire pool is enclosed by a white translucent curtain. Lighting is dimmed and diffuse.

A video camera is firmly mounted at an exactly vertical position above the center of the pool, such that the pool completely fills the video image. Video recordings are taken at PAL resolution (720×576 pixels, 25 frames per second), at the least. The videos are evaluated by an automatic tracking system that allows for flawless detection of the animals movements with time.

Mice are placed into the water using a special devise that is mounted on a stick, so they can be watered at exactly defined spots along the rim of the pool without the operator entering the cabin made up of the translucent curtain.

Experimental Design

In each session, mice are placed into the pool at predefined sites and are allowed to swim for 60s. Animals' motion tracks are recorded by a video tracking system, and parameters are computed from which conclusions regarding the animals' learning aptitude can be drawn (most notably the period until the mouse hits the platform for the first time=“escape latency”; further details see below). If a mouse succeeds in finding the platform it is left resting there for a short period of time (˜15 s). Otherwise, after 60s of swimming, the mouse is guided to the platform by the operator and allowed to rest for ˜15s. Afterwards, it is picked up by the operator, dried gently and returned to its housing or prepared for the next swim.

On each day of experiments, one trial per mouse is performed in the early morning. Each trial consists of two consecutive swims originating from two different quadrants, but never from the target quadrant. Exact watering sites (and platform positions whenever applicable) are assigned randomly for each swim of each day, but do not differ between the individual mice during that day.

If mice turn out to learn extremely slowly the number of swims per trial or trials per day may be increased (and vice versa). Moreover, in many mouse strains younger animals learn very quickly, so after four or five days of training, escape latencies remain constant at a few seconds only which is equally true in treated as in untreated animals. However, for the statistical evaluation, it is of advantage if the curve of escape latencies over training days does not saturate but rather decreases monotonically. Therefore, an experimental design is used in which the problem to solve becomes more difficult with training progress: On predefined days the platform is replaced with a smaller one while the platform's center coordinates remain the same.

If and when platforms are swapped may be determined independently for each series of experiments and ought to depend on the outcomes of the preceding series.

In each series of experiments mice are subjected to three different kinds of tasks:

-   -   Cued place navigation. The platform is marked with a cue, and         the mouse is allowed to swim until it finds the platform. This         procedure tests associative learning and serves for dividing         mice into two experimental groups the learning aptitudes of         which are as similar as possible. Moreover, in the second and         further series of experiments, cued place navigation supports         blanking recollection of the position of the platform in         preceding series.     -   Hidden platform acquisition training. The platform is invisible         to the mouse and located at the same position as during the         preceding swim. This task allows for monitoring the mouse's         progress in recalling the exact location of a hidden platform         (“spatial learning”).     -   Probe trial testing. In this task, the on-demand platform is         maximally lowered underneath the surface and the mouse is         allowed to swim freely searching for it. Probe trial testing         assesses the animals' absolute recall which, in this context,         can be also interpreted as conviction, persistence or certainty         regarding the platform location. The conventional approach to         interpreting the experiment is that animals that have firmly         fixed the location of the platform will more persistently search         in a limited location and thus spend more time in the zone next         to the platform.     -   In probe trial testing, there is a risk that the inability to         find the platform may reduce the incentive to swim to the         platform zone. In order to keep these irritations as small as         possible, the modalities of human rescue ought to remain the         same so there is some spatial constancy despite the absence of         the platform. Therefore, after 60s of swimming the platform is         lifted to just beneath the surface, the mouse is guided there by         the operator and allowed to rest for ˜15s before being taken out         of the apparatus.     -   On all days of probe trial testing, only one swim is performed.

Approximately 60 minutes prior to each trial, mice are treated daily with either 5 ng/kg NRG-1 beta-ECD (suspended in black 6 mouse serum and provided i.v. in a volume of 20 μL per mouse) or with 20 μL of vehicle i.v., respectively.

On day 1 of the first series of experiments, all mice in the study receive sham treatment only. Thereafter, mice are assigned to the Neuregulin and the control groups such that the distributions of escape latencies match in both groups.

In each series of experiments the following chronology is adhered to:

-   -   day 1. Cued platform search with platform of size 10 cm and         position changing for each swim.     -   day 2. Cued platform search with platform of size 10 cm and         position changing for each swim.     -   day 3. Cued platform search with platform of size 10 cm and         position changing for each swim.     -   day 4. Cued platform search with platform of size 10 cm and same         position as the last one on day 3.     -   day 5. Hidden platform search with platform of size 15 cm and         same position.     -   day 6. Hidden platform search with platform of size 15 cm and         same position.     -   day 7. Hidden platform search with platform of size 15 cm and         same position.     -   day 8. Hidden platform search with platform of size 10 cm and         same position.     -   day 9. Probe trial testing.     -   day 10. Hidden platform search with platform of size 10 cm and         same position.     -   day 11. Hidden platform search with platform of size 10 cm and         same position.     -   day 12. Hidden platform search with platform of size 5 cm and         same position.     -   day 13. Hidden platform search with platform of size 5 cm and         same position.     -   day 14. Hidden platform search with platform of size 5 cm and         same position.     -   day 15. Probe trial testing.

It may be necessary to aid unlearning of the platform position from a preceding set of experiments by allowing the mice to freely swim for a few days without platform present.

The rate of learning is assessed by monitoring each training/test session and noting the success of the animals in finding the platform as well as the evolution of the search strategy from skirting the sides of the pool to moving away from the sides to search in the near to central area where the platform lies.

Measured Parameters

From the animals' video recordings, each mouse's motion track is extracted and exported as a series of x, y, and time coordinates for further processing. Care needs to be taken to reliably identify each track's staring point and to avoid tracking errors. Simultaneously, a number of parameters are computed from which conclusions regarding the animals' learning aptitude can be drawn (see below). Parameter recordings are halted after 60s or if the mouse has found the platform (whichever happens earlier).

For the definition of parameters to be computed from the animals' track records the following zones are defined (see FIG. 12):

In order to keep evaluations as flexible as possible, four concentric target zones (centered about the platform) of 5.5 to 30 cm diameter are employed.

Parameters computed from the animals' track records include:

Total distance travelled

Overall average speed

Number of entries to the pool center

Time in the pool center

Latency to first entry to the pool center

Distance travelled to first entry to the pool center

Number of entries to the inner area

Time in the inner area

Distance travelled in the inner area

Latency to first entry to the inner area

Distance travelled to first entry to the inner area

and for each target zone 1 to 4 and the target quadrant

Number of entries to the zone

Time in the zone

Distance travelled in the zone

Latency to first entry to the zone

Distance travelled to first entry to the zone

Distance from beginning of track to nearest point of zone

Average distance from the zone when outside the zone

Minimum distance from the zone when outside the zone

Time to minimum distance from the zone when outside the zone

Time getting closer to the zone

Time getting further away from the zone

Time moving towards the zone

Time moving away from the zone

Number of head entries to the zone

Time of head in the zone

Distance of head travelled in the zone

Latency to first entry of head to the zone

Average distance of head from the zone when outside the zone

Minimum distance of head from the zone when outside the zone

Initial heading error

Average heading error

Number of exits from the zone

For each day of the experiment, the readings of parameters of learning progress in the treated and untreated groups are compared to each other statistically.

On examining the track records of individual mice, a human observer is able to come to a fairly realistic perception of the animals' assertiveness in locating the platform which is not fully reflected in the measured parameter values. Therefore, track records are also manually inspected and the animals' recall of the platform position is rated.

Results:

Those animals treated with a daily dose of 3 ng/kg NRG-1 beta-ECD i.v. 30 min prior to training were significantly better in learning-related parameters than the vehicle treated group.

Neuregulin not only improved learning, but treated animals had also developed more advanced search strategies: More treated animals entered the inner area of the pool (11 vs. 7, p=0.019), entries to the inner area occurred more often (2.17 vs. 0.92 times, p=0.02), time spent and distance travelled in the inner zone was longer (6.51s vs. 2.13s, p=0.09 and 0.64m vs. 0.25m, p=0.031, respectively).

The results of the learning experiments in a Morris water maze are summarized in FIG. 2.

Example 3 Schizophrenia Amphetamine-Induced Hyperactivity in the Rat Methods:

The method, which detects antipsychotic and anti-Parkinson activity, follows that described by Costall et al. 1978 and uses an activity meter similar to that described by Boissier and Simon 1966.

Amphetamine induces hyperactivity in this test situation. Hyperactivity is antagonized by classical and atypical antipsychotics acting on dopaminergic systems at the limbic level, and is potentiated by anti-Parkinson drugs.

Rats are injected with d-amphetamine (3 mg/kg i.p.) and are immediately placed in the activity meter.

The activity meter consists of 12 covered Plexiglass cages (40×25×25 cm) contained within a darkened cabinet. Each cage is equipped with two photocell assemblies at each end of the cage, 3 cm above the floor, in order to measure the number of movements by each animal (one per cage) from one end of the cage to the other. Two additional photocell assemblies are placed at 20 cm above the floor to record rearing. The scores for activity and rearing are recorded by computer over 10-minute intervals and cumulated over a 30-minute period.

15 rats were studied per group. The test was performed blind.

The test substance was evaluated at 8 doses, administered i.v. 15 minutes before amphetamine, and compared with a vehicle control group. The experiment also included a control group not treated with amphetamine. Haloperidol (0.125 mg/kg i.v.), administered under the same experimental conditions, was used as reference substance.

The experiment therefore included 16 groups.

Data were analyzed by comparing treated groups with appropriate control using unpaired Student's t tests.

Results:

As shown in FIG. 3, NRG-1 beta-ECD in a dose-dependent manner inhibits the amphetamine-induced hyperactivity in an animal model for schizophrenia.

Conspicuously, the experiments reveal outstanding properties of NRG-1 beta-ECD:

-   -   The effects shown in FIG. 3 are strongest in the second half of         the experiment (minutes 20-40). In the first 20 minutes only a         smaller effect can be found, this delayed effect points to         further processing of the protein.     -   The effective concentrations of NRG-1 beta-ECD used here are         about 200-1000 times lower than those used for typical control         neuroleptica like Haloperidol (125 μg/kg).     -   In contrast to Haloperidol, Clozapine, Olanzapine etc. there are         no negative effects observed in that NRG-1 beta-ECD does not         reduce activity of test animals below vehicle control levels.

Example 4 Schizophrenia Prepulse Inhibition

Rodents with NRG1 knock-out show significantly impaired prepulse inhibition (PPI) linking NRG1 to schizophrenia. A widely used surrogate measure of psychosis in animal models, PPI is considered a schizophrenia endophenotype. It was reported that there are neurophysiological effects of missense mutations of a nonsynonymous single nucleotide polymorphism located on NRG1 (rs3924999) on PPI after extensive genotyping, in both schizophrenia and healthy control populations (Hong et al. 2007). We tested the effect of NRG-1 beta-ECD on PPI. The results so far may be summarized as follows:

At 105 dB, NRG-1 beta-ECD showed a general trend towards re-establishment of PPI (+26%, +23% and +36%, at 150, 300 and 600 ng/kg respectively), although the effect did not reach statistical significance and was not observed at 115 dB. It had no effects on spontaneous movements in the absence of stimulus at 150 or 300 ng/kg but significantly decreased spontaneous movements in the absence of stimulus at 600 ng/kg (−20% and −29%, on average and peak intensities respectively, p<0.05, this is similar to aripiprazole). NRG-1 beta-ECD had no effects on the reaction to the pre-pulse alone.

The results so far suggest the absence of significant effects on apomorphine-induced PPI deficits for Propsy100 over the dose-range 150-300 ng/kg and a decrease of spontaneous movements as well as a trend towards re-establishment of PPI at 600 ng/kg i.v. in the Pre-pulse Inhibition (PPI) Test in the rat (deficits induced by apomorphine).

In this series of experiments, the reference substance, aripiprazole, had weak but significant activity at 3 mg/kg i.p., but not at 10 mg/kg i.p., in the same test.

All together and under conditions used, NRG-1 beta-ECD appears to affect PPI at higher concentrations around 600 ng/kg. These results surprisingly open a novel understanding of recent neurobiological research implying (NRG1) as one of the leading candidate genes in schizophrenia.

Example 5 Learning and Memory in an Animal Model for Alzheimer's Disease (APPPS Dt Mice)

The animal experiments testing learning and memory with or without application of the soluble extracellular domain of Neuregulin 1 β (NRG-1 beta-ECD) in a Morris water maze set up described above for normal mice, have been repeated double transgenic mouse model for cerebral amyloidosis (APPPS mice(Meyer-Luehmann et al. 2006; Radde et al. 2006)).

Here again those animals which were treated with a daily dose of NRG-1 beta-ECD (here 200 ng/kg i.p. were applied) 30 min prior to training were significantly better in learning-related parameters than the vehicle treated group.

Neuregulin not only improved learning, but treated animals had also developed more advanced search strategies: More treated animals entered the inner area of the pool (12 vs. 7, p=0.009), entries to the inner area occurred more often (2.0 vs. 0.7 times, p=0.03), time spent and distance travelled in the inner zone was longer (5.3 s vs. 2.1 s, p=0.09 and 0.7m vs. 0.3m, p=0.025, respectively).

The results of the learning experiments with APPPS mouse model of ceretral amyloidosis and Alzheimer's disease in a Morris water maze are summarized in FIG. 4.

Example 6 Neuregulin 1-Beta MPTP Mouse Model of Parkinson's Disease Methods:

Male C57BI/6 mice of 10 weeks were used in the MPTP (1-Methyl-4-phenyly-1,2,3,6-tetrahydropyridine) model for Parkinson's disease.

Brain tissue is dissected (Substantia Nigra, Striatum, Cortex) of 10 weeks old male C57B16 mice (N=10 per group) at different times after treatment (0, 1, 3, 7, 21 days) with NaCl (controls) or MPTP (acute and subchronic models). The methods follow published procedures (Hoglinger et al. 2007; Hoglinger et al. 2004).

Time after injection of MPTP Treatment 0 days 1 days 3 days 7 days 21 days MPTP acute N = 10 N = 10 N = 10 N = 10 N = 10 MPTP chronic N = 10 N = 10 N = 10 N = 10 N = 10 NaCl N = 10 Total: N = 110

MPTP is dissolved as a powder in 0.9% NaCl and is injected intraperitoneal (acute application: 4×20 mg/kg, each at 2 hour intervals; chronic application: 5×30 mg/kg, each at 24 hour intervals). These injections take approx. 10 seconds, animals were sacrificed at defined time points (see table) by cervical dislocation. The procedures follow published protocols (Hoglinger et al. 2007; Hoglinger et al. 2004; Liberatore et al. 1999; Przedborski and Vila 2003; Vila and Przedborski 2003).

0 days after last MPTP-administration: Loss of striatal dopaminergic nerves

1 day after last MPTP-administration: Beginning microglia-activation

3 days after last MPTP-administration: Maximum of microglia-activation

7 days after last MPTP-administration: Maximum of astrocyte-activation

21 days after last MPTP-Administration: Maximum of cell death

21 days after intracerebral infusion of NRG-1 beta-ECD and a control peptide via Alzet Mini pumps, followed by MPTP treatment (acute vs. chronic), a histological quantification of dopaminergic neurons of the middle brain was performed according to stereological principles. Also, a biochemical quantification of dopamine and its metabolites in the striatum is performed by HPLC. Procedures are performed according to published protocols (Hoglinger er et al. 2007; Hoglinger et al. 2004).

Treatment Infusion N MPTP acute NRG-1 beta-ECD N = 10 Control acute NRG-1 beta-ECD N = 10 MPTP chronic NRG-1 beta-ECD N = 10 Control chronic NRG-1 beta-ECD N = 10 MPTP acute Control peptide N = 10 Control acute Control peptide N = 10 MPTP chronic Control peptide N = 10 Control chronic Control peptide N = 10 Total: N = 80

Results:

As shown in FIG. 5, the results of the HPLC measurements of dopamine and its metabolites reveal a clear effect of administration of NRG-1 beta-ECD during MPTP insult, in this model for Parkinson's disease.

The effects are non-classical: whereas there is no significant effect upon dopamine levels, neither during MPTP-insult nor in acute or chronic controls of NRG-1 beta-ECD administration, there are pronounced and clear effects on the concentrations of DOPAC and HVA. The chronic administration of NRG-1 beta-ECD results in a clear and significant reduction of this metabolite in the absence of MPTP insult, whereas in the acute regimen only a slight decrease is observed. During the chronic condition of the MPTP insult, NRG-1 beta-ECD causes a significant increase of homovanillic acid (HVA), an effect, which is even more pronounced in the absence of MPTP-insult.

These results are can be interpreted by a down regulation of MAO-B during the chronic NRG-1 beta-ECD administration and/or COMT up regulation. Under the conditions applied a huge and significant positive effect on survival of dopaminergic neurons was observed. NRG-1 beta-ECD is also highly neuroprotective in this model. Given the ip injection during this series of experiments, the clear efficacy also proves again that NRG-1 beta-ECD is highly efficient in passing the blood brain barrier.

FIG. 6 shows the metabolic scheme which appears to be affected by NRG-1 beta-ECD administration: dopamine is converted by MAO-B to DOPAC and by COMT to 3-MT; homovanillic acid is subsequently generated form both metabolites by COMT from DOPAC and by MAO-B from 3-MT;

NRG-1 beta-ECD administration is obviously regulating activities of both enzymes.

Even more important and as shown in FIG. 7, in the MPTP model of Parkinson's disease there is a clear and significant neuroprotective effect of NRG-1 beta-ECD becoming apparent by histological quantification of dopaminergic neurons of the middle brain. The stereological method has been described elsewhere (Liberatore et al., 1999, Przedborski & Vila, 2003; Vila & Przedborski, 2003; Höglinger et al., 2004; Höglinger et al., 2007).

Taken together, there is a surprisingly clear and beneficial neuroprotective effect in the MPTP animal model of Parkinson's disease: The effects prove again that the intraperitoneal administration of very low concentrations of NRG-1 beta-ECD (e.g. 20 ng/kg) is sufficient to achieve efficacy and thus that NRG-1 beta-ECD passes the blood brain barrier. Also the complex influence on dopamine metabolites (HPLC results; FIG. 5) points to regulation of MAO-B and COMT by NRG-1 and NRG-1 beta-ECD.

Example 7 Identification of an Acidic Posttranslational Isoform of NRG-1 Beta-ECD as the Active Principle

We have published evidence, that in learning and memory a particular posttranslational acidic isoform of NRG-1 beta-ECD is the active form (Schillo et al. 2005a). Here we show that similar patterns are observed in animal models of Alzheimer's disease and post-mortem brain tissue from Alzheimer's and Parkinson's disease patients. We conclude that this acidic isoform is the active principle.

Methods:

For staining Western blots we used the following antibodies: anti-NRG1-ECD, rabbit polyclonal (sc-28916 Lot: 12905 Santa Cruz; H-210) Neuregulin-1 (H-210) is a rabbit polyclonal antibody raised against amino acids 21-230 mapping within an N-terminal extracellular domain of Neuregulin-1 isoform HRG-α of human origin. Neuregulin-1 (H-210) is recommended for detection of Neuregulin-1 isoforms HRG-α, HRG-α1A, HRG-α2B, HRG-α3, HRG-β1, HRG-β2, HRG-β3 (GGF), GGF2 and SMDF of mouse, rat and human origin by Western Blotting (starting dilution 1:200, dilution range 1:100-1:1000), immunoprecipitation [1-2 μg per 100-500 μg of total protein (1 ml of cell lysate)] and immunofluorescence (starting dilution 1:50, dilution range 1:50-1:500).

Secondary antibodies were:

Anti goat, HRP

sc-2922 Lot: C1405 Santa Cruz

Anti rabbit, HRP

Sc-2054 Lot: G 2005 Santa Cruz

Next to immunostaining we performed MALDI-TOF and Q-TOF mass spectrometry to confirm NRG-1 beta-ECD.

Now we find a very similar pattern in APPPS mouse model of cerebral amyloidogenesis and Alzheimer's disease as shown in FIG. 8. The concentration of this particular acidic isoform of NRG-1 beta-ECD at roughly a pl of 5.0 is considerably higher in treated APPPS mice which are at the same time better learners.

In FIG. 8 two representative images are shown of each, a treated good learning animal (top) and non-treated animal with inferior learning performance. (below).

FIG. 9 shows the results of a Western Blot experiment using post mortem cortical material from each 9 Alzheimer patients and age-matched controls. It clearly reveals, that the NRG-1 β-ECD fragment is significantly less abundant in the Alzheimer cases. As an internal control the abundance of NRG-12 was measured, which appears not to be affected by the memory-loss associated with the disease.

A further investigation of the this specific Alzheimer- and memory-associated isoform of NRG-1 β-ECD by Western blots of 2-dimensional gels (2D-PAGE) of the same post mortem human brain material used for FIG. 9, reveals as shown by representative examples in FIG. 10, that it is indeed the acidic isoform of NRG-1 β-ECD which is diminished in the Alzheimer condition.

CONCLUSIONS

We present here for the first time functional evidence of in vivo effects of posttranslational modifications of the transcript of nrg-1 gene, in particular a truncated form generated by proteolytic cleavage, comprising the extracellular domain of NRG-1 beta with MW 15-35, pl 4-10; more specifically we found an antipsychotic activity in animal models for schizophrenia, probably based on regulation of MAO-B and COMT, at concentrations of 5-600 ng/kg (i.v.). In contrast to control neuroleptics which are used at concentrations which are 100-1000-fold higher, there was no negative effect observed.

Moreover we found a neuroprotective effect in MPTP model of Parkinson's disease at concentrations of 3-300 ng/kg (i.v.)

Moreover we found a positive effect on memory- and learning in respective animal models (Morris water maze) for learning and cerebral amyloidosis and Alzheimer's disease

Given the adverse effects of many atypical antipsychotics, currently in use (Haddad and Sharma 2007) we conclude that soluble NRG-1-ECD fragment with EGF domains of SMDF, NRG-1 alpha, but in particular NRG-1 beta might be useful as a stand-alone or co-medication for the treatment of schizophrenia, bipolar disorder and depression.

It might also be used in the same sense in other diseases of the central nervous system, like neurodegenerative disorders like Alzheimer's and Parkinson's disease, amyotrophic lateral sclerosis, multiple sclerosis, stroke, traumatic brain and spinal chord injuries.

Soluble NRG-1-ECD proteins have these very broad effects due to a central role in neuronal signal transduction, in particular mediating glutamate signalling and excitotoxicity, which plays a central role in all indications mentioned above (Schrattenholz and Soskic 2006).

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1. A method of effecting neuroprotection in a subject suffering from a condition selected from the group consisting of schizophrenia, bipolar disorder, depression, Alzheimer's disease, epilepsy, multiple sclerosis (MS), Amylotrophic Lateral Sclerosis (ALS), stroke, traumatic brain injury, and spinal cord injury, comprising administering to said subject a recombinant soluble Type I Neuregulin-1 β isoform which is an about 15 to about 35 kD N-terminal fragment of Type I Neuregulin-1β.
 2. The method of claim 1, wherein said recombinant soluble Type I Neuregulin-1 β isoform is the first 150 to 250 amino acids of Type I Neuregulin-1 β.
 3. The method of claim 1, wherein said recombinant soluble Type I Neuregulin-1 β isoform is the first 245 to 250 amino acids of Type I Neuregulin-1 β.
 4. The method of claim 1, wherein said recombinant soluble Type I Neuregulin-1 β isoform crosses the blood-brain barrier.
 5. The method of claim 1, wherein said recombinant soluble Type I Neuregulin-1 β isoform reduces dopaminergic cell death in said subject compared to a subject that is not treated with said recombinant soluble Type I Neuregulin-1 β isoform.
 6. The method of claim 1, wherein said recombinant soluble Type I Neuregulin-1 β isoform is administered to said patient in combination with a further medicament.
 7. The method of claim 6, wherein the further medicament is selected from the group consisting of acetylcholine esterase inhibitors, MAO-B-inhibitors, COMT-inhibitors, Memantine-type channel blockers, dopamine receptor agonists, serotonine receptor agonists or antogonists, catecholamine reuptake inhibitors, serotonine reuptake inhibitors.
 8. The method of claim 6, wherein the further medicament is a medicament for the treatment of psychotic disorders such as schizophrenia, bipolar disorders and depression.
 9. The method of claim 6, wherein the further medicament is a medicament for the treatment of Alzheimer's disease.
 10. The method of claim 6, wherein the further medicament is a medicament for the treatment of Multiple Sclerosis (MS).
 11. The method of claim 6, wherein the further medicament is a medicament for the treatment of Amyotrophic Lateral Sclerosis (ALS).
 12. The method of claim 6, wherein the further medicament is a medicament for the treatment of epilepsy.
 13. The method of claim 6, wherein the further medicament is a medicament for the treatment of stroke.
 14. The method of claim 6, wherein the further medicament is a medicament for the treatment of traumatic brain injury.
 15. The method of claim 6, wherein the further medicament is a medicament for the treatment of spinal cord injury.
 16. The method of claim 1, wherein the Type I Neuregulin-1 β isoform has an isoelectric point (pl) of about 4 to about
 10. 17. The method of claim 1, wherein the Type I Neuregulin-1 β isoform is a modified polypeptide, wherein the modifications are selected from phosphorylation, glycosylation, methylation, myristoylation, oxidation and any combination thereof.
 18. The method of claim 1, wherein said recombinant soluble Type I Neuregulin-1 β isoform is administered in an amount of 3 to 600 ng/kg body weight of the subject to be treated.
 19. The method of claim 1, wherein said recombinant soluble Type I Neuregulin-1 β isoform is administered in an amount of 150 to 300 ng/kg body weight of the subject to be treated.
 20. The method of claim 1, wherein said recombinant soluble Type I Neuregulin-1 β isoform is administered in an amount of about 3, 5, 20, 50, 150, 200, 300 or 600 ng/kg body weight of the subject to be treated.
 21. The method of claim 1, wherein said recombinant soluble Type I Neuregulin-1 β isoform is administered in an amount of about 20 ng/kg body weight of the subject to be treated. 